• Chan-Woo Park, Hyeon-Jun Eun, Sung-Hak Oh, Hyun-Jun Kim, Seung-Jae Lim, and Youn-Soo Park.
• Department of Orthopedic Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea.
• J Arthroplasty. 2019 Mar 1; 34 (3): 527-533.

BackgroundThere is a lack of understanding on relationship between the femoral geometry and outcomes of total hip arthroplasty (THA). We investigated clinical and radiographic outcomes of THA using a cementless tapered wedge stem in patients with Dorr type A proximal femoral morphology and compared with those of type B femurs at a minimum follow-up of 5 years.MethodsWe analyzed 1089 hips (876 patients) that underwent THA using an identical cementless tapered wedge stem. We divided all femurs into 3 types (Dorr type A, B, and C). Type A and B femurs were statistically matched with age, gender, body mass index, and diagnosis by using propensity score matching. Clinical, radiographic results, and stem survivorship were compared between the matched 2 groups.ResultsA total of 611 femurs (56%) were classified as type A, 427 (39%) as type B, and 51 (5%) as type C. More radiolucent lines around femoral stems were found in type A femurs (7.8%) than in type B femurs (2.5%) (P < .001). Patients with radiolucency showed worse Harris Hip Score (86.2 points) compared with those without radiolucency (93.0 points) (P < .001). The stem survivorship of type A femur (97.8%) was lower than that of type B femur (99.5%) (P = .041). The reasons for femoral revision in type A femurs were periprosthetic fracture (67%), aseptic loosening (22%), and deep infection (11%).ConclusionsThis study showed a higher rate of complications after THAs using a cementless tapered wedge stem in Dorr type A femurs than those performed in type B femurs.Copyright © 2018 Elsevier Inc. All rights reserved.

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